This power point describes in nut shell hte definition, etiopathogenesis, clinical features, gross , histological and MRI findings in adenomyosis and its management

1. ADENOMYOSIS

2.  DEFINITION
ETIOPATHOGENESIS
CLINICAL FEATURES
GROSS FINDINGS
HISTOLOGICAL FINDINGS
MRI FINDINGS
MANAGEMENT

3. DEFINITION
 Presence of endometrial islands within the uterine
wall i.e., myometrium
 Usually endometrial glands are present only in
endometrial layer of uterus ,which gets sloughed
off regularly during menses
 But in this condition there occurs signifying down
growth of endometrial tissues into the
myometrium

4. ETIOPATHOGENESIS
 Elderly women aged above 40
 Younger women are also susceptible
 No clear pathogenesis .
 Believed as an endometrial tissue down
growth
 ASSOCIATIONS:
• Uterine fibromyomas
• Pelvic endometriosis
• Endometrial carcinomas

5. CLINICAL FEATURES
 Present with menorrhagia & progressively
increasing dysmenorrhea
 Pelvic discomfort, backache, dyspareunia
 Painful symmetrical enlargement of uterus
suggests adenomyosis following investigations
 Uterus size- resembles 3 month pregnancy
 Uterus may be symmetrically or asymmetrically
enlarged
 MRI is superior to USG for diagnosing
adenomyosis

6. GROSS FINDINGS

7. GROSS FINDINDS (CONTD…)
 Uterus appears symmetrically enlarged
resembling not more than 14 weeks size
 Asymetrical enlargement of uterus may also be
seen in some cases which may confused with
myoma
 Affected area shows peculiar and diffuse
involvement of myometrium
 Posterior wall- dark hemorrhagic areas in b/w
normal areas
 Cross section shows localized nodular
enlargement
 Enlargement-due to hyperplasia of smooth

8. HISTOLOGY
 ENDOMETRIAL ISLAND PRESENT
DEEP WITHIN
STROMA(MYOMETRIUM)

9. MRI FINDINGS
SYMMETRICAL
ENLARGEMENT
ASYMMETRICAL
ENLARGEMENT

10. MANAGEMENT
 HYSTERECTOMY with or without salpingo-
oopherectomy - if women aged 40 years
above and indicated
 If not interested or if she is young
• NSAIDs (medical)
• GnRH(hormonal)
• Mirena IUCD
• TCRE(trans cervical resection
of endometrium)

11. THANK YOU